Can valid diagnoses be reached in initial clinical interviews? Comparison of initial clinical interview, structured interview and symptom checklists

The present study investigated whether diagnoses based on a structured clin ical interview (SKID) and those made during an initial clinical interview a re the same, what additional information is gained by using symptom checkli sts (SCL-90-R) in diagnostic assessment, and how patients rate these differ ent types of interviews. Initial interviews were conducted with 88 patients (mean age 35 years) who consulted the Ambulatory Psychological Service of the University of Trier Drier to psychotherapy. Agreement between diagnoses based on SKID and clinical interviews was good for anxiety, eating, and so matoform disorders, but was significantly lower for affective disorders. Th e SCL-90-R seemed to measure nonspecific symptoms. Patients rated initial c linical interviews as more positive and motivating for the desired psychoth erapy than the SKID. Advantages and disadvantages of different diagnostic m easures used in psychotherapy are discussed in terms of their diagnostic va lidity and therapeutic efficacy.